抄録
It has been generally believed that neck clipping is the safest and most authentic treatment for cerebral aneurysms. However, aneurysmal necks have various shapes and thicknesses and it is not always possible to get a complete obliteration of the neck.
In the last five years, 216 patients were submitted to direct surgery of the aneurysm and of these, six showed rebleeding or regrowth afterwards.
Pre- and post-operative angiograms, infra operative and postmortem findings were studied in each cases and led to the following conclusions.
(1) Wrapping of the residual neck with muscle or Aron-alfa could not prevent the recurrence.
(2) Local fragility of the arterial wall caused by arteriosclerosis or infection could lead to the recurrence of the aneurysm.
(3) Hypertension just after operation could aggravate aneurysmal regrowth by increasing hemodynamic stress.
(4) Postoperative angiogram should be done in all cases, particularly those of thick and broad neck aneurysms and wrapping aneurysms.
